Gum tissue guide, systems and methods of producing and utilizing the same

ABSTRACT

A method, device and system for modifying the gingival margin of a patient is disclosed. A method includes obtaining an electronic model of the dentition of a patient, determining an incision path along the gingival surface based on the electronic model, generating and fabricating a guide arrangement to assist in cutting the gingival surface of the patient, mounting the guide arrangement to the dentition of the patient, and cutting the gingival surface of the patient with the assistance of the guide arrangement. A guide arrangement includes a mounting portion and a template portion coupled to the mounting portion along the gingival surface of the guide arrangement and positioned to provide a desired incision path. A system includes a three dimensional scanner, a computer system and a fabricating device.

CROSS REFERENCE TO RELATED APPLICATION

This application is a Continuation of U.S. patent application Ser. No.15/066,783, filed on Mar. 10, 2016, entitled GUM TISSUE GUIDE, SYSTEMSAND METHODS OF PRODUCING AND UTILIZING THE SAME, which is a Divisionalof U.S. application Ser. No. 14/227,670, filed on Mar. 27, 2014,entitled GUM TISSUE GUIDE, SYSTEMS AND METHODS OF PRODUCING ANDUTILIZING THE SAME, which is a Continuation of U.S. application Ser. No.13/547,532, filed on Jul. 12, 2012, entitled GUM TISSUE GUIDE, SYSTEMSAND METHODS OF PRODUCING AND UTILIZING THE SAME, now U.S. Pat. No.8,721,329, which claims priority to U.S. Provisional Patent ApplicationSer. No. 61/507,297, filed on Jul. 13, 2011, entitled GUM TISSUE GUIDE,SYSTEMS AND METHODS OF PRODUCING AND UTILIZING THE SAME, the disclosuresof which are hereby incorporated by reference in their entireties. Tothe extent appropriate, a claim of priority is made to each of theabove-disclosed applications.

TECHNICAL FIELD

The disclosure relates generally to a method, system, and device formanipulating the gingiva of a patient; and, more particularly, to aguide arrangement for use in cutting the gingival margin, and systemsand methods for producing and utilizing the same.

BACKGROUND

Dental professionals routinely manipulate the gingiva of a patient for avariety reasons related to dental surgery, preventive maintenance, andaesthetics. For example, some dental patients can be unhappy with thepost dental surgery aesthetics or natural aesthetics of their smile,including the presence of excess gingiva and/or unsymmetrical gingivalmargins and lines. Dental professionals sometimes address this concernby cutting the gingiva to remove excess gingiva and/or to improve thesymmetry of the gingival lines, thereby increasing the generalaesthetics of the patient's smile. The cutting of the gingiva isperformed by hand (e.g., using a laser or a knife). Such techniques areinherently prone to human error and may not accurately reproduce apre-operation plan incorporating the desired end result.

There arises a need in the art to provide a guide arrangement, andsystems and methods for accurately allowing the manipulation of gingivabased on a pre-operation plan.

SUMMARY

The present disclosure provides for devices, systems, and methods formanipulating the gingiva of a patient; and, more particularly, a guidearrangement for use in cutting the gingival margin, and systems andmethods for producing and utilizing the same.

In general, a dental professional develops a pre-operation plan formanipulating the gingiva of a patent to improve the aesthetics of thepatient's smile. The plan includes obtaining an electronic model of atleast part of a dentition of a patient, including a gingival surface.Determining an incision path along the gingival surface based at leastpartially on the electronic model image. Generating an electronic modelof a guide arrangement including generating a mounting portion of theguide arrangement that is configured to fit over the dentition of thepatient and generating a template portion of the guide arrangement thatextends from the mounting portion towards the gingival surface of thepatient. In a preferred embodiment, the template portion defines a guideedge along the incision path. And fabricating the guide arrangementbased on the electronic model of the guide arrangement.

Following pre-operation planning and fabricating the guide arrangement,the guide arrangement can be mounted over the dentition of the patientand the gingival surface cut using the fabricated guide arrangement.

The guide arrangement used for cutting the gingival of a patient caninclude a mounting portion configured to couple to the dentition of thepatient and a template portion coupled to the mounting portion along thegingival surface of the guide arrangement and positioned to provide adesired incision path. In a preferred embodiment, the guide arrangementfurther comprises a safety lip along the template portion of the guidearrangement to limit the proximity of a cutting tool to the gingivalsurface, prevent accidental cutting of the guide arrangement and improvethe movement of a cutting tool across the template portion of the guidearrangement.

A system for fabricating the guide arrangement can include athree-dimensional scanner; a computing system; and a fabricating device.The scanner digitizes the dentition of the patient to generateelectronic model images of the patient's teeth. The computing systemenables display, manipulation, storage, and transmission of theelectronic model images. The computing system also enables the user todesign an electronic model of a guide arrangement configured to aid inmanipulating the gingiva of a patient. The fabrication device enablesfabrication of the alignment device based on the electronic model.

While the disclosure will be described with respect to preferredembodiment configurations and with respect to particular devices usedtherein, it will be understood that the disclosure is not to beconstrued as limited in any manner by either such configuration orcomponents described herein. Also, while the particular types ofscanning devices, computing devices, and fabrication devices used in thepreferred embodiment are described herein, it will be understood thatsuch particular components are not to be construed in a limiting manner.Instead, the functionality of those devices should be appreciated. Theseand other variations of the disclosure will become apparent to thoseskilled in the art upon a more detailed description of the disclosure.

The advantages and features which characterize the disclosure arepointed out with particularity in the claims annexed hereto and forminga part hereof. For a better understanding of the disclosure, however,reference should be had to the drawing which forms a part hereof and tothe accompanying descriptive matter, in which there is illustrated anddescribed a preferred embodiment of the disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

Referring to the drawing, wherein like numerals represent like partsthroughout the several views:

FIG. 1A illustrates a general frontal overview of a portion of adentition of a patient including central incisors, lateral incisors, andcanines in accordance with aspects of the disclosure;

FIG. 1B is an enlarged view of one of the teeth of FIG. 1A;

FIG. 2 is a flowchart illustrating an operational flow of an exampletreatment process in accordance with the principles of the presentdisclosure;

FIG. 3 is a flowchart illustrating an operational flow of an exampleplan process by which a treatment plan is formed for a patient;

FIG. 4 shows an example incision path displayed over a dentition modelin accordance with aspects of the disclosure;

FIG. 5 is a flowchart illustrating an operational flow of one exampledesign process by which the dental professional creates an incision pathalong which the dental professional will cut during surgery;

FIG. 6 is an enlarged view of a portion of the dentition model of FIG. 4in which control points are moveable to adjust a contour of the incisionpath;

FIG. 7 is a schematic view of one example implementation of a guidearrangement suitable for use in guiding a dental professional in cuttingalong a planned incision path in accordance with aspects of the presentdisclosure;

FIG. 8 is a cross-sectional view of the example guide arrangement ofFIG. 7 positioned over a tooth of a patient with a buccal side of thetooth on the left and the lingual side of the tooth on the right;

FIG. 9 is a flowchart illustrating an operational flow for an examplemanufacturing process by which a guide arrangement may be produced;

FIG. 10 is a schematic block diagram of an example computing system onwhich at least portions of the manufacturing process of FIG. 9 may beimplemented;

FIG. 11 is a flowchart illustrating an operational flow for a designprocess by which a guide arrangement model may be produced in accordancewith aspects of the disclosure;

FIG. 12 is a front elevational view of an example guide model positionedover a dentition model so that a guide edge of the guide model followsthe incision path;

FIG. 13 is a plan view of a dentition model including teeth and gingivaand including outer boundaries for an example guide arrangement modelthat are defined by line segments connecting control points (e.g.,points P1, P2, P3, etc);

FIG. 14 shows a slice of the dentition model and guide model taken alongthe F14-F14 line of FIG. 13;

FIG. 15 is a flowchart illustrating an operational flow for surgicalprocess using a fabricated guide arrangement;

FIG. 16 shows a fabricated guide arrangement positioned over one or moreteeth of the patient and a cutting tool aligned with a guide edge of theguide arrangement;

FIGS. 17 and 18 show another example implementation of a guidearrangement having a mounting portion and a template portion formed ofdifferent materials;

FIGS. 19 and 20 show another example implementation of a guidearrangement including a stopping lip formed by a protrusion from abuccal side of the guide arrangement; and

FIG. 21 shows another example implementation of a guide arrangementhaving a stopping lip formed by a notch in the template portion of theguide arrangement.

DETAILED DESCRIPTION

The present disclosure provides for methods, devices, and systems formanipulating the gingiva of a patient; and, more particularly, a guidearrangement for use in cutting the gingival margin, and systems andmethods for producing and utilizing the same.

In general, a dental professional can plan and implement a course oftreatment to manipulate the gingiva of a patient to produce a moreaesthetically pleasing gingival line. In accordance with aspects of thedisclosure, the dental professional may utilize one or more guidearrangements to aid the dental professional in cutting the gingival inaccordance with the treatment plan. In accordance with aspects of thedisclosure, a suitable guide arrangement may be designed and fabricatedusing one or more electronic models of the dentition of the patient.

FIGS. 1A and 1B generally show a portion of a dentition of a patient.The illustrated portion includes six teeth 2, including the centralincisors, lateral incisors, and canines. The roots of the teeth 2 arecovered by gingiva 4. The crowns of the teeth 2 emerge from the gingiva4 at a gingival margin 12. Each tooth crown has a maximum height 10(e.g., the vertical distance between the gingiva line 12 to an occlusalend of tooth 2) and a maximum width 8 across the tooth 2. The gingivalmargin 12 defines the boundary between the teeth 2 and the gingiva 4 ofa patient.

FIG. 2 is a flowchart illustrating an operational flow for a treatmentprocess 100 in accordance with aspects of the disclosure. The treatmentprocess 100 is implemented by the dental professional to plan andimplement a course of treatment to modify the gingiva 4 of a patient.Referring to FIG. 2, the treatment process 100 begins at a start module102, implements any suitable initial procedures, and proceeds to a planoperation 104.

In the plan operation 104, a dental professional creates a treatmentplan for modifying the gingiva 4 of a patient. The treatment planincludes determining an incision path (e.g., see FIG. 4) along which thedental professional will cut the gingiva 4 during surgery. A dentalprofessional plans a course of treatment for a patient by analyzing thedentition of the patient and determining a preferred gingival margin. Indetermining a preferred gingival margin, a dental professional mayconsider the symmetry of the gingival margin 12 for each tooth 2 and thesymmetry of the gingival margin 12 between adjacent teeth 2.

Other example factors in determining a preferred gingival margin 12include a target height 10 of each tooth 2, a target width 8 of eachtooth 2, a preferred height 10 to width 8 ratio of each tooth 2, acurrent location of the gingival margin 12, a location of a gingivalzenith, and the general aesthetics desired by the patient. Furtherdetails regarding such treatment planning can be found, e.g., in Tucker,L M, Framing Your Masterpiece: Guidelines for Treatment Planning theIdeal Soft Tissue Framework.).

In an obtain operation 106, a dental professional can obtain a guidearrangement (e.g., see guide arrangement 16 of FIG. 7) to aid the dentalprofessional in cutting along the incision path. The guide arrangementis configured to be positioned over one or more teeth 2 of the patientand to provide a clear indication of the incision path along the gingiva4 of the patient. Additional details pertaining to suitable guidearrangements, as well as the design and manufacture thereof, areprovided herein.

In an implement operation 108, the dental professional mounts theobtained guide arrangement onto one or more teeth of the patient andcuts the patient's gingiva along a guide edge provided by the guidearrangement. The original gingival margin is hidden from view beneaththe guide arrangement during the initial incisions. In one embodiment,the guide arrangement is similar to a mouth guard, and may cover theentire upper or lower teeth 2 of a patient. After cutting along theincision path, the dental professional may detach the guide arrangementand removes soft tissue located between the original gingival margin andthe incision.

The treatment process 100 performs any appropriate concluding proceduresand ends at a stop module 109.

FIG. 3 is a flowchart illustrating an operational flow of one exampleplan process 150 by which the dental professional creates a treatmentplan. For example, the plan process 150 may be used to implement theplan operation 104 of FIG. 1. FIG. 4 shows an example treatment planhaving an incision path 35 resulting from the plan process 150. The planprocess 150 begins at a start module 152, performs any appropriateinitialization procedures, and proceeds to an obtain operation 154.

In an obtain operation 154, the dental professional obtains one or moreelectronic models 30 (FIG. 4) of the dentition of the patient. Eachelectronic model 30 includes representations of one or more teeth 32emerging from a gingival surface 34 at a gingival margin 33. In someembodiments, the electronic model 30 represents the teeth 32 located onone of the mandible and the maxilla of the patient. In otherembodiments, however, the electronic model 30 represents the teeth 32located on both the mandible and the maxilla. In still otherembodiments, the electronic model 30 represents the teeth 32 of only theportion of the dentition for which gingival modification is planned.

In certain embodiments, the electronic model 30 is formed from apolygonal mesh. In one example embodiment, the electronic model 30 isformed from a triangular polygonal mesh. In other embodiments, however,other types of electronic models 30, such as voxel-based models, can beutilized. In some implementations, the dental professional may retrieveone or more electronic models 30 from memory on a local or remotecomputer. In other implementations, the dental professional may receiveone or more electronic models 30 from a third party (e.g., via email,via network connection, via storage hardware, etc.).

In still other implementations, the dental professional may generate theelectronic models 30 from positional data obtained, directly orindirectly, from the patient. For example, in some implementations, theobtain operation 154 acquires spatial data of the patient's dentition byscanning a dental cast of the patient's dentition and generating theelectronic model 30 based on the obtained spatial data. In otherimplementations, the obtain operation 154 acquires the spatial data byintra-orally scanning the actual dentition of the patient. In stillother implementations, the obtain operation 154 scans a negativeimpression taken of the patient's dentition.

Still referring to FIG. 3, in a design operation 156, the dentalprofessional can define an incision path 35 (FIG. 4) along the gingivalsurface 34 based at least partially on the obtained electronic model 30.In some embodiments, the dental professional defines the incision path35 by displaying the electronic model 30 of the dentition on a displaydevice and mapping a desired gingival contour over the displayedelectronic model through a user interface of the display device (e.g.,see FIG. 4).

In some implementations, the dental professional determines a desiredgingival contour based on a variety of factors, including the targetheight 10 (FIG. 1A) of each tooth 2, the target width 8 (FIG. 1A) ofeach tooth 2, a preferred height 10 to width 8 ratio, the location ofthe actual gingival margin (e.g., 12 of FIG. 1B), the location of thegingival zenith, and the general aesthetics desired by the patient. Incertain implementations, the identification of an appropriate incisionpath 35 can be supplemented by software that automatically identifiesthe gingival margin 33 between the gingiva 34 and the teeth 32.

In an optional archive operation 158, the dental professional may storethe treatment plan in memory (e.g., of a local computer, of a remotecomputer, etc.). For example, in some implementations, the dentalprofessional may store the electronic model 30 of the dentition and adigital representation of the incision path 35.

The example plan process 150 performs any appropriate completionprocedures and ends at a stop module 160.

FIG. 5 is a flowchart illustrating an operational flow of one exampledesign process 170 by which the dental professional creates an incisionpath 35 along which the dental professional will cut during surgery. Forexample, the design process 170 may be used to implement the designoperation 156 of FIG. 3. FIG. 6 shows a portion of the exampleelectronic model 30 including a tooth 32 emerging from a gingiva 34 at agingival margin 33. FIG. 6 also shows an incision path 35 over theelectronic model 30. The design process 170 begins at a start module172, performs any appropriate initialization procedures, and proceeds toa plot operation 174.

The plot operation 174 provides one or more control points that definethe incision path 35. In some implementations, the plot operation 174initially provides the control points along the gingival margin 33. Forexample, a representative point P1 is shown on the gingival margin 33 inFIG. 6. In other implementations, a user may position the control pointsmanually using a graphic user interface in the plot operation 174. Instill other implementations, the plot operation 174 may automaticallyposition the control points along a suggested incision path 35 basedprogrammed factors. For example, in one implementation, the plotoperation 174 may suggest control point positions based on apredetermined offset from the gingival margin 33.

A modify operation 176 adjusts the location of the control points torevise the incision path 35. In some implementations, a user may drag orotherwise relocate one or more control points manually using a graphicuser interface. In other implementations, a user may change parameters(e.g., an offset from the gingival margin 33) being used by the computerto suggest control point locations. In the example shown in FIG. 6, thecontrol point P1 on the gingival margin 33 is shown being moved to a newlocation (designated at P1′). Moving the control point P1 shifts thelines/curves connecting the control points.

The design process 170 performs any appropriate completion proceduresand ends at a stop module 178.

FIG. 7 is a schematic view of one example implementation of a guidearrangement 16 suitable for use in guiding a dental professional incutting along a planned incision path. The guide arrangement 16 includesa mounting portion 22 and a template portion 24 that is coupled to themounting portion 22. The mounting portion 22 defines an interface 23that is configured to seat on one or more teeth of the patient. Thetemplate portion 24 is designed to provide a guide edge 25 that followsthe designed incision path. The guide edge 25 also provides a surfacealong which the cutting tool may be positioned and moved (e.g., slid) tocut the gingiva of the patient during treatment.

FIG. 8 is a cross-sectional view of an example guide arrangement 16positioned over a tooth 2 of a patient with a buccal side 20 of thetooth 2 on the left and the lingual side 18 of the tooth 2 on the right.The interface region 23 seats on an occlusal surface of the tooth 2. Theinterface region 23 is customized to the patient so that the guidearrangement 16 will mount to the dentition in only one orientation so asto indicate where on the gingiva 4 an incision path 35 is planned.

The template portion 24 of the guide arrangement extends over the buccalside 20 of the tooth 2 towards the gingiva 4. A guide edge 25 alignswith the designed incision path 35 at the gingiva 4. The guide edge 25aligns a cutting section 62 of a cutting tool 60 with the incision path35. In certain implementations, the guide edge 25 of the templateportion 24 represents the contour of the patient's gingival margin posttreatment. During the procedure, the original gingival margin is hiddenfrom view beneath the guide arrangement 16. After cutting, soft tissuelocated between the original gingival margin and the incision may beremoved.

In some implementations, the guide arrangement 16 at least partiallycovers the buccal, occlusal and lingual surfaces of the tooth 2. Inother implementations, the guide arrangement 16 may contact only thebuccal surface 20 and the occlusal surface of the tooth 2. In stillother implementations, the guide arrangement 16 may contact only thebuccal surface 20 of the tooth 2. The extent to which the guidearrangement 16 covers the tooth 2 depends on how the dental professionalattaches the guide arrangement 16 to the tooth 2 (e.g., adhesive,friction, or the patient's bite).

The dental professional can mount the guide arrangement 16 to thepatient's dentition in a variety of ways. In some implementations, theinterface region 23 of the guide arrangement 16 is sufficiently offsetfrom the tooth 2 to provide space for adhesive. In otherimplementations, the interface region 23 of the guide arrangement 16 issufficiently tight to the tooth 2 to provide a friction fit against thetooth 2. In still other implementations, an occlusal surface 26 of theguide arrangement 16 may be provided at an appropriate height to allow apatient to bite down on the guide arrangement 16 to hold the guide inposition.

The guide arrangement 16 may be designed to cover anywhere from two tosixteen teeth 2 depending on the preferences of the dental professional,the number of teeth 2 where gingiva 4 will be removed, and the method inwhich the guide arrangement 16 will be attached to the teeth 2. Forexample, the guide arrangement 16 may cover fewer teeth when using anadhesive for attachment than when using a friction fit.

Referring now to FIGS. 9-14, one or more guide arrangements 16 may becustom designed and manufactured for each patient. FIG. 9 is a flowchartillustrating an operational flow for an example manufacturing process110 by which a guide arrangement 16 may be produced. FIG. 10 is aschematic block diagram of an example computing system 200 on which atleast portions of the manufacturing process 110 may be implemented. Themanufacturing process 110 begins at a start module 111, performs anyappropriate initialization procedures, and proceeds to an obtain module112.

The obtain module 112 acquires a treatment plan for a patient. Thetreatment plan includes an incision path along which a dentalprofessional will cut into the gingiva 4 of a patient during a surgicalprocedure. In certain implementations, the obtain module 112 receives anelectronic model 30 of the patient's dentition including the incisionpath 35 mapped over the gingival portion 3 of the electronic model 30.In some implementations, the obtain module 112 retrieves the treatmentplan from electronic memory of a local or remote computer. In otherimplementations, the obtain module 112 obtains the treatment plan froman email or from storage hardware. In still other implementations, theobtain module 112 obtains positional data for the incision path separatefrom the electronic model 30.

A design operation 114 generates an electronic model 300 (FIG. 12) of aguide arrangement 16 based, at least in part, on the electronic model 30of the dentition. In some implementations, the design operation 114includes generating a mounting portion 322 of the guide arrangementmodel 300 that is configured to support the guide arrangement 16 whenthe guide arrangement 16 is positioned in the patient's mouth. Forexample, generating the mounting portion 322 includes generating aninterface region 323 of the guide model 300 to provide proper fit andplacement of the guide arrangement 16 based on interactions with theteeth 32 of the dentition model 30. The design operation 114 alsoincludes generating a template portion 24 of the guide arrangement model300 to extend towards the gingiva 4 of the patient to define a guideedge 25 along the incision path 35.

A fabricate operation 116 produces the guide arrangement 16 inaccordance with the guide arrangement model 300. In someimplementations, the fabricate operation 116 sends the guide model 300or spatial data pertaining thereto to a third party for fabrication. Inother implementations, the fabricate operation 116 sends the guide model300 or spatial data pertaining thereto to a fabrication device toproduce the guide arrangement 16. In some implementations, thefabrication device mills the guide arrangement 16 from a biocompatiblematerial, such as dental wax or metal. In other implementations, thefabrication device prints the guide arrangement 16 from a biocompatibleusing a rapid prototyping machine. In still other implementations, thefabricate operation 116 produces a pattern from which the guidearrangement 16 may be cast.

The manufacturing process 110 performs any appropriate completionprocedures and ends at a stop module 118.

As shown in FIG. 10, an example design and production system 200 onwhich example processes of the present disclosure can be executedincludes a computing system 220. In some implementations, the computingsystem 220 is configured to implement the obtain operation 112 anddesign operation 114 of the manufacturing process 110 of FIG. 9. Forexample, the system is configured to enable display, manipulation,storage, and transmission of electronic models and/or spatial data. Thesystem also can be configured to enable a user to manipulate theelectronic model or portions thereof to plan a desired gingival contourof the teeth.

In some implementations, the computing system 220 also is configuredimplement the fabricate operation 116 of the manufacturing process 110of FIG. 9. For example, in certain implementations, the computing system220 is coupled to a fabrication device 270 that is capable of producing(e.g., print or milling) objects based on electronic models generated bythe computing system 220. In other implementations, the computing system220 may be coupled to a scanner 210 or other source of positionalinformation.

One example implementation of the computing system 220 includes aprocessor unit 222, read only memory (ROM) 224, random access memory(RAM) 228, and a system bus 230 that couples various system componentsincluding the RAM 228 to the processor unit 222. The system bus 230 maybe any of several types of bus structures including a memory bus ormemory controller, a peripheral bus and a local bus using any of avariety of bus architectures. A basic input/output system 226 (BIOS) isstored in ROM 224. The BIOS 226 contains basic routines that helptransfer information between elements within the computing system 220.

The computing system 220 further includes a hard disk drive 232 forreading from and writing to a hard disk, a magnetic disk drive (notshown) for reading from or writing to a removable magnetic disk, and anoptical disk drive 234 for reading from or writing to a removableoptical disk, such as a CD-ROM, DVD, or other type of optical media. Thehard disk drive 232, magnetic disk drive, and optical disk drive 234 canbe connected to the system bus 230 by a hard disk drive interface (notshown), a magnetic disk drive interface (not shown), and an opticaldrive interface (not shown), respectively. The drives and theirassociated computer-readable media provide nonvolatile storage ofcomputer readable instructions, data structures, programs, and otherdata for the computing system 220.

Although the exemplary environment described herein employs a hard diskdrive 232, a removable magnetic disk, and removable optical disk drive234, other types of computer-readable media capable of storing data canbe used in the exemplary system. Examples of these other types ofcomputer-readable mediums that can be used in the exemplary operatingenvironment include magnetic cassettes, flash memory cards, digitalvideo disks, and Bernoulli cartridges. All of these physical devices areexamples of computer-readable storage devices.

A number of program modules may be stored on the ROM 224, RAM 228, harddisk drive 232, magnetic disk drive, or optical disk drive 234,including an operating system 236, one or more application programs 238,other program modules, and program (e.g., application) data 240.

A user may enter commands and information into the computing system 220through input devices 242, such as a keyboard, touch screen, and/ormouse (or other pointing device). Examples of other input devices mayinclude a microphone, joystick, game pad, satellite dish, and documentscanner. These and other input devices are often connected to theprocessor unit 222 through an I/O port interface 244 that is coupled tothe system bus 230. Nevertheless, these input devices 242 also may beconnected by other interfaces, such as a parallel port, game port, or auniversal serial bus (USB). A monitor 246 or other type of displaydevice is also connected to the system bus 230 via an interface, such asa video adapter 248. In addition to the display device 246, computingsystems typically include other peripheral output devices (not shown),such as speakers and document printers.

The computing system 220 may operate in a networked environment usinglogical connections to one or more remote computers. Examples of remotecomputers include personal computers, servers, routers, network PC's,peer devices and other common network nodes, and typically include manyor all of the elements described above relative to the computing system220. In certain embodiments, the network connections can include a localarea network (LAN) or a wide area network (WAN). Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets, and the Internet 250.

When used in a WAN networking environment, the computing system 220typically includes a modem 252 or other means for establishingcommunications over the wide area network, such as the Internet 250. Themodem 252, which may be internal or external, can be connected to thesystem bus 230 via the I/O port interface 244. When used in a LANnetworking environment, the computing system 220 is connected to thelocal network 254 through a network interface or adapter 256. In anetworked environment, program modules depicted relative to thecomputing system 220, or portions thereof, may be stored in the remotememory storage device. It will be appreciated that the networkconnections shown are exemplary and other means of establishing acommunications link between the computers may be used.

In certain embodiments, the fabrication device 270 includes a rapidprototyping machine configured to print wax patterns. Examples of such arapid prototyping machine are the SLA® systems produced by 3D Systems ofRock Hill, S.C. However, any type of fabrication device 270 may be usedwithout deviating from the spirit and scope of the disclosure. Incertain embodiments, the fabrication device 270 can be connected to thecomputing system 220 via an appropriate interface 258. In a preferredembodiment, the fabrication device is configured to print the guidearrangement in surgical grade polymer. Although in other embodiments thefabrication device will print the guide arrangement in any materialsuitable for use as a dental guide arrangement.

The interface 258 can connected to the bus 230 such that the electronicmodel data may be retrieved from the appropriate or desired memorylocation. In some embodiments, the interface 258 converts the electronicmodels generated on the computing system 220 to a format readable by thefabrication device 270. In one example embodiment, the interface 258converts the electronic model to an STL file. The converted file can betransmitted to the fabrication device 270 using a direct line connectionor using a networked connection described above.

In certain embodiments, the design and production system 200 alsoincludes a scanner 210 configured to implement the obtain operation 106of the treatment process 100 of FIG. 2. For example, a three-dimensionalscanner 210 can be coupled to the computing system 220 via anappropriate scanner interface 260. The scanner interface 260 isconnected to the bus 230 such that the scanned data may be stored in theappropriate or desired memory location, manipulated by the CPU 222,displayed on the display device 246, etc. Preferred scanners include alaser line scanner arranged and configured for scanning line study casts(e.g., plaster casts), such as the dental scanner manufactured byGeoDigm Corporation of Minnesota. The operation and scanning methodologyused by such a line scanner is generally described in U.S. Pat. No.6,217,334. However, any suitable scanner 210 may be used and a number ofother methodologies might be employed to generate the scanned imagedata.

Portions of the preferred embodiment constructed in accordance with theprinciples of the present disclosure utilize a computer and aredescribed herein as implemented by logical operations performed by acomputer. The logical operations of these various computer implementedprocesses are generally performed either (1) as a sequence of computerimplemented steps or program modules running on a computing systemand/or (2) as interconnected machine modules or hardware logic withinthe computing system. The implementation is a matter of choice dependenton the performance requirements of the computing system implementing thedisclosure. Accordingly, the logical operations making up theembodiments of the disclosure described herein can be variously referredto as operations, steps, or modules.

As just discussed in reference to FIG. 10, a system of the presentdisclosure may comprise a three-dimensional scanner configured to obtainspatial data corresponding to dentition of a patient, a computing systemcoupled to the three-dimensional scanner, the computing systemconfigured to generate an electronic model image representing thedentition of the patient based on the spatial data obtained by thescanner, the computing system also configured to generate an electronicmodel image of a guide arrangement, the guide arrangement configured todefine a desired gingival contour of the teeth; and a fabricating devicecoupled to the computing system, the fabricating device configured tofabricate the guide arrangement based on the electronic model images ofthe guide arrangement.

FIG. 11 is a flowchart illustrating an operational flow for a designprocess 130 by which a guide arrangement model 300 may be produced. Forexample, the design process 130 may be used to implement the designoperation 114 of manufacturing process 110 of FIG. 9. The design process130 begins at a start module 131, performs any appropriateinitialization procedures, and proceeds to a generate operation 133 atwhich the guide model 300 is produced.

In some implementations, the generate operation 133 generates a standardelectronic model having a default size and shape. In otherimplementations, the generate operation 133 generates the guide model300 based on parameters (e.g., spatial data for the teeth, the gingivalmargin, etc.) obtained from the dentition model 30 or other spatialdata. In some implementations, the generate operation 133 produces aguide model 300 sized and shaped to fit over a single tooth. In otherimplementations, the generate operation 133 produces a guide model 300sized and shaped to fit over multiple adjacent teeth.

A first define operation 135 defines or adjusts the outer boundaries ofthe guide model 300. In some implementations, the first define operation135 creates the template portion 324 of the guide model 300 by creatinga guide edge 325 along the contours of the incision path 35. Forexample, FIG. 12 is a front elevational view of an example guide model300 positioned over a dentition model 30 so that a guide edge 325 of theguide model 300 follows the incision path 35.

In some implementations, the first define operation 135 enables atechnician to interactively adjust the outer boundaries using controlpoints. For example, FIG. 13 is a plan view of a dentition model 30including teeth 32 and gingiva 4. Outer boundaries for the guidearrangement model 300 are defined by line segments connecting controlpoints (e.g., points P1, P2, P3, etc). A technician can move one or moreof the control points to different locations to adjust the distancebetween the buccal surface of the guide model 300 and the buccal surfaceof each tooth 32 and/or to adjust the distance between the lingualsurface of the guide model 300 and the lingual surface of each tooth 32.

FIG. 14 shows a slice of the dentition model 30 and guide model 300taken along the F14-F14 line of FIG. 13. As shown, a control point P3 onthe guide edge 325 aligns with the incision path 35. In someimplementations, in the first define operation 135, a technician maytake one or more such slices along the dentition of FIG. 13 to view theinteraction between the guide model 300 and the dentition model 30. Ateach slice, the positions of the control points may be adjusted. Incertain implementations, positions of the control points, such ascontrol point P3, are modified to better align with the incision path35.

In other implementations, in the first define operation 135, thepositions of the control points may be modified to increase or decreasea thickness of the guide model 300 at different locations along thesurface of the tooth 32. For example, the control points my bemanipulated to increase the thickness D1 of the template portion 324 ofthe guide model 300, the thickness D2 of the mounting portion 322 of theguide model 300, and/or the thickness D3 of the occlusal surface of theguide model 300.

A second define operation 137 creates the interface region 323 of theguide model 300 by defining the interior contours of the guide model300. In some implementations, the interface region 323 of the guidemodel 300 is shaped to fit over at least the buccal side of the tooth32. In certain implementations, the interface region 323 of the guidemodel 300 is configured to fit over the occlusal surface of the tooth32. In certain implementations, the interface region 323 of the guidemodel 300 extends from the buccal side of the tooth 32, over theocclusal surface, to a lingual side of the tooth 32.

As shown in FIG. 14, in some implementations, one or more control pointscan be provided along the interface region 323 to enable a technician tointeractively adjust the contours of the interface region 323. Forexample, the second define operation 137 may adjust the control pointsto increase or decrease on offset O defined between the interface region323 and the tooth 32. In some implementations, the offset O is formedsufficiently large, for example, to accommodate adhesive to bond afabricated guide arrangement 16 to a tooth 2 of the patient (see FIGS.7-8). In other implementations, the offset O is formed sufficientlysmall, for example, to provide an interference fit (i.e., friction fit)between a fabricated guide arrangement 16 and the tooth 2 of thepatient.

The design operation 130 performs any appropriate completion proceduresand ends at a stop module 139.

FIG. 15 is a flowchart illustrating an operational flow for surgicalprocess 190 using a fabricated guide arrangement 16. For example, thesurgical process 190 may be used to at least partially execute theimplement operation 108 of the treatment process 100 of FIG. 2. Thesurgical process 190 begins at a start module 191, performs anyappropriate initialization procedures, and proceeds to a mount operation193.

In a mount operation 193, a dental professional positions the guidearrangement 16 at an appropriate location in the patient's mouth. Forexample, as shown in FIG. 16, the guide arrangement 16 may be positionedover one or more teeth 2 of the patient. The template portion 24 extendstowards the gingival surface 4 until the guide edge 25 aligns with adesired incision path 35. In other implementations, however, the guidearrangement 16 may be positioned over a fully or partially edentulousarch of the patient.

In some implementations, mounting of the guide arrangement 16 can beimplemented using a friction-fit between the guide arrangement 16 andthe teeth 32. For example, in some instances the friction is greatenough to forego the use of any dental adhesive, gum, or glue. In otherimplementations, the guide arrangement 16 is mounted to the teeth 2using an adhesive to maintain a fixed position while the dentalprofessional cuts the gingiva 4 of the patient. In still otherembodiments, the guide arrangement 16 is mounted to the teeth 2 byhaving the patient bite down on the guide arrangement 16. Further still,a dental professional can use all of some of the above describedmounting methods.

Following mounting of the guide arrangement 16, a dental professionalimplements an align operation 195 in which a cutting tool 60 ispositioned so that a cutting section 62 extends towards the gingiva 4 ata point along the incision path 35. In some implementations, the cuttingtool 60 includes a scalpel, gingivectomy knife, or other such sharp. Insome such implementations, the blade 62 or pointed tip that abuts theguide edge 25 of the guide arrangement 16. In other suchimplementations, a handle of the cutting tool 60 may abut the guide edge25 of the guide arrangement 16. In still other implementations, thecutting tool 60 includes a laser that fits with the guide arrangement 16to align the laser beam along the incision path 35.

In a cut operation 197, the dental professional makes one or moreincisions into the gingiva 4 using the cutting section 62 of the cuttingtool 60. In some implementations, the dental professional slides thecutting tool 60 along the guide edge 25 to trace a portion of theincision path. In other implementations, the dental professional slidesthe cutting tool 60 forwardly and rearwardly along the guide edge 25 ata point along the incision path 35. In still other implementations, thedental professional “eyeballs” the movements of the cutting tool 60without any physical contact between the cutting tool 60 and the guide16.

The surgical process 190 performs any appropriate completion proceduresand ends at a stop module 199.

FIGS. 17 and 18 show another example implementation of a guidearrangement 50 having a body 51 including a mounting portion 52 and atemplate portion 54. The mounting portion 52 defines an interface region53 that is substantially the same as interface region 23 of the firstexample guide arrangement 16. Various embodiments of the mountingportion 52 may extend over the buccal surface, occlusal surface, and/orlingual surface of one or more teeth 2. The template portion 54 definesa guide edge 55 that follows the contours of a planned incision path.

In this example implementation, however, the mounting portion 52 andtemplate portion 54 may be formed from two different materials. Forexample, the template portion 54 may be formed of dental metal or otherhard material to withstand interactions with the cutting section 62 ofthe cutting tool 60. The mounting portion 52 may be formed out of anybiocompatible material (e.g., dental wax, metal, etc.). In certainimplementations, the material forming the mounting portion 52 need notbe as strong or rigid as the material forming the template portion 54.

In some implementations, electronic models of the mounting portion 52and the template portion 54 are designed to fit together in a singleguide model (e.g., model 300 of FIG. 12). In certain implementations,the mounting portion 52 and the template portion 54 may be fabricatedseparately and subsequently attached together (e.g., using adhesive,welding, or other such fastening techniques). For example, thefabricated template portion 54 may be attached to a buccal section 56 ofthe mounting portion 52.

In other implementations, the template portion 54 may be cast or milledfirst and the mounting portion 52 may be cast around the templateportion 54. For example, in one implementation, the fabricated templateportion 54 may be attached to a pattern of the mounting portion to forma casting assembly. The casting assembly is invested, the pattern isdestroyed, and material forming the mounting portion 52 is poured intothe mold to fuse to the template portion 54.

FIGS. 19 and 20 show another example implementation of a guidearrangement 70 having a body 71 including a mounting portion 72 and atemplate portion 74. The mounting portion 72 defines an interface region73 that is substantially the same as interface region 23 of the firstexample guide arrangement 16. Various embodiments of the mountingportion 72 may extend over the buccal surface, occlusal surface, and/orlingual surface of one or more teeth 2. The template portion 74 definesa guide edge 75 that follows the contours of a planned incision path. Asnoted above, the mounting portion 72 and the template portion 74 may beformed of different material.

The guide arrangement 70 also includes a stopping lip 77 at the buccalside 76 of the guide arrangement 70. The stopping lip 77 is sized,shaped, and positioned to limit the proximity of a cutting tool 65 tothe gingival surface 4 of the patient. In some implementations, thestopping lip 77 protrudes from the buccal side 76 of the guidearrangement 70. In other implementations, the stopping lip 77 is definedby a notch 87 in the buccal side 86 of the guide arrangement 80 (seeFIG. 21, showing an embodiment including the guide arrangement 80, themounting portion 82, the template portion 84, the guide edge 85, thebuccal side 86, and the notch 87, as well as a tooth 2, the gingeva 4,and the gingival margin 12.). In certain implementations, the stoppinglip 77 has an edge formed from metal, a dental grade material resistantto cutting, or a material providing reduced friction to facilitatemovement of the cutting tool 65 along the guide edge 75.

In some implementations, the stopping lip 77 facilitates using a dentallaser as the cutting tool 65. For example, the laser 65 may bepositioned so that a portion of the laser body abuts the stopping lip77. While resting against the stopping lip 77, the dental laser ismaintained at the optimal distance from the gingiva 4 to cut the gingiva4 safely.

In certain implementations, the cutting tool 65 is abutted to a stoppinglip 77 on the template portion 74 of the guide arrangement 70 to limitthe proximity of the cutting tool 65 to the gingival surface 4. In someimplementations, the stopping lip 77 limits the distance between thecutting tool 65 and the gingival surface 4 to a range of about 0.01 mmto about 2.0 mm. Indeed, in some implementations, the stopping lip 77limits the distance to a range of about 0.15 mm to about 1.8 mm. Incertain implementations, the stopping lip 77 limits the distance tobetween about 0.2 mm and about 1.6 mm. In certain implementations, thestopping lip 77 limits the distance to between about 0.25 mm and about1.4 mm. In certain implementations, the stopping lip 77 limits thedistance to between about 0.3 mm and about 1.2 mm. In certainimplementations, the stopping lip 77 limits the distance to betweenabout 0.35 mm and about 1.0 mm. In certain implementations, the stoppinglip 77 limits the distance to between about 0.4 mm and about 0.8 mm. Inone implementation, the stopping lip 77 limits the distance to betweenabout 0.45 mm and about 0.6 mm. In one implementation, the stopping lip77 limits the distance to between about 0.45 mm and about 0.55 mm.

Although embodiments of the present disclosure have been described withrespect to digitizing a dental cast of a patient, it should beappreciated that the principles of the present disclosure can also beapplied to a digitized impression or a direct scan of the dentition of apatient. In the former case, a computer can invert the scannedimpression to provide a positive image of the patient's teeth.

The foregoing description of the exemplary embodiments of the disclosurehas been presented for the purposes of illustration and description.They are not intended to be exhaustive or to limit the disclosure to theprecise forms disclosed. Many modifications and variations are possiblein light of the above teaching. It is intended that the scope of thedisclosure be limited not with this detailed description, but rather bythe claims appended hereto.

What is claimed is:
 1. A guide arrangement comprising: a mountingportion configured to couple to the dentition of the patient; and atemplate portion coupled to the mounting portion along the gingivalsurface of the guide arrangement and positioned to provide a desiredincision path.
 2. The guide arrangement of claim 1, wherein the mountingportion and the template portion are fabricated as a single arrangement.3. The guide arrangement of claim 1, wherein the mounting portioncouples to the buccal surface of the dentition of the patient.
 4. Theguide arrangement of claim 1, wherein the mounting portion couples to atleast the buccal and occlusal surfaces of the dentition of the patient.5. The guide arrangement of claim 1, wherein the dentition of thepatient includes between two and 16 teeth.
 6. The guide arrangement ofclaim 1, further comprising a safety lip along the template portion ofthe guide arrangement.
 7. The guide arrangement of claim 6, wherein thesafety lip is positioned to limit the proximity of a cutting tool to thegingival surface.
 8. The guide arrangement of claim 1, wherein thearrangement is fabricated from surgical grade polymer.